List of illustrations |
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xi | |
About the Author |
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xii | |
Acknowledgments |
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xiii | |
Introduction: The Story of Dan and the Purposes of This Book |
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1 | (8) |
Part I Starting Points and Potential Destinations |
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1 Smart Adults with Late-Recognized Asperger Syndrome and Success |
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11 | (8) |
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This chapter excerpts the autobiographical writings of four extremely successful adults with Asperger syndrome. |
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Included are: a boy who dropped out of school before eighth grade and later became a university professor of journalism who won a Pulitzer prize as an outstanding music critic; a woman trapped in feeling "nerdy, shy, and socially inappropriate," shed her shame to become a successful writer and publisher mentoring others seeking self-understanding; a high school dropout who engineered exploding guitars for the rock band KISS, who runs an auto repair shop, and wrote a New York Times bestseller, Look me in the eye; and a gifted animal scientist born with classical autism, now Asperger syndrome, who thinks in pictures, has designed one third of the livestock handling facilities in the U.S., has published six books, and lectures widely on autism. |
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Part II Children and Teenagers |
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Joshua suffered from severe social anxiety which required carefully adjusted treatment with medication, but he also had considerable difficulty from bullying by his peers. |
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His parents repeatedly told him that he was "gifted" and that his classmates were just jealous of him. |
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Much of his peer difficulty was reactive to his condescension toward classmates. |
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He was a gifted musician and functioned better in a new school where he could be with other students involved in music, but he needed considerable support to learn how to adapt to peer culture. |
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Sam benefitted from participation in sports where he-did quite well, but he often antagonized peers and classmates by criticizing their performance. |
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His parents had chronic conflicts with one another over how much to confront Sam with unacceptable behavior vs. supporting him. |
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They also needed help to avoid giving him ineffective strategies for dealing with peers who teased him. |
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Bella is a very bright and creative girl who distanced herself from classmates and spent most of her free time playing video games. |
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She was terrified of the transition from middle school to high school. |
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She responded well to therapeutic role-playing sessions to try out different ways of interacting with peers and to extra support from a high school counselor who helped to prepare her for transition to high school. |
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Jeremy's parents were struggling with marital conflict as well as about how to deal with Jeremy's frequent problems with school. |
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When we began work together he was "on strike" in his classes insisting that he would not cooperate with teachers until they stopped the special education support services he found humiliating. |
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He also struggled with his conflicting loyalties for each parent and his fear that he would become like his mentally ill uncle. |
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His mother's sudden onset of cancer complicated the family dynamics and Jeremy's need for support. |
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Justin was socially isolated and would bang his head on school walls and leave the classroom anytime he made a mistake. |
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Collaboration with his teachers helped set up interventions to avoid his maladaptive reactions to frustration. |
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His grandmother brought him to her home daily after school to get his homework done. |
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His family was initially fearful about using medications, but fine-tuned medication plus psychotherapy with Justin, his father and grandmother helped him improve his emotional disruptions, his schoolwork and interacting with peers. |
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Psychotherapy also helped him to address his concerns about growth and sexuality. |
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Part III Young Adults |
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Anthony was obsessed with his desire to develop a relationship with a girlfriend, but he lacked the ability to understand how she could be less enthused about her brief experience in dating him than he was. |
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He lacked "theory of mind," the ability to understand and empathize with another person's point of view different from his own. |
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Despite cautions from several friends and me, he continued to try to see her even after being served a restraining order. |
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Only after being jailed for violating that order was he able to begin to understand what went wrong. |
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Drew had a long history being brilliant with computer science, but also maintaining an arrogant and defiant attitude toward his parents and many of his teachers, not caring about how others felt about him. |
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His parents were unable to confront him effectively about this when he was in elementary school, high school or university. |
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When he totally wrecked three cars in motor vehicle accidents, they bought him a new pickup truck and allowed him to use their credit card for a 3 month solo trip. |
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He and his mother were unable to sustain treatment. |
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Sandra's inability to complete an undergraduate degree was due largely to her chronic difficulties with a type of Obsessive-Compulsive Disorder perfectionism combined with untreated ADHD. |
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However, Sandra also felt intense social anxiety and was very fearful about growing up and separating from her mother. |
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Her emotional turmoil and underlying depression led to occasional episodes of cutting herself which she described as a way to help herself feel emotions that otherwise she could not experience. |
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She needed a writing tutor and a course of psychotherapy to develop more self-acceptance and better understanding of her conflict. |
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Jorge had been diagnosed with ADHD, encopresis, and daytime enuresis prior to his evaluation with me when he was 8 years old. |
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His parents were divorced and his mother home-schooled him until eighth grade. |
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A bitter dispute between his parents about whether he should be treated with medication was resolved by the court. |
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With medication his schoolwork improved; he was placed in a small private school where he did very well. |
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For college, Jorge moved to another state where he lived with his father and eventually graduated with honors, despite continuing difficulties with independent functioning and social interactions. |
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Part IV Adults |
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Richard is extremely bright and was very successful in functioning within the confines of the academic world of college and law school, but he was not at all adept at managing social-emotional interactions in the work setting with his superiors or with others on the staff. |
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He was unable to develop an adequate mentor relationship with senior partners in either law firm. |
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He was not able to understand the importance of completing an assignment his supervisor was depending on; he could not see the situation from his supervisor's point of view. |
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He had similar problems in understanding the needs and expectations the girlfriend he was living with. |
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Although she had been very successful in her schooling and in becoming an attorney despite some language processing problems, Loretta's 40th birthday was upsetting for her because she felt like a failure for having ended a 4 year engagement and for her inability to sustain emotional closeness to others. |
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She struggled with intense ambivalence about social relationships and, like many other adults with Asperger syndrome, her ongoing conflicts over intimacy led to a significant depression in midlife. |
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Gary was able to relate comfortably with the students he was teaching and coaching, but he found it quite difficult to develop reciprocal relationships with people his own age. |
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His relationship with the lesbian woman he met on the camp staff was his first experience in trying to develop a relationship with a woman. |
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When that relationship was lost, he was devastated. |
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The relationship he formed with another woman when he was with her as a patient on a psychiatric ward led quickly to their living together, getting married and having a child. |
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Soon after the birth of his son the relationship between Gary and his wife deteriorated emotionally for both of them, but he was able to sustain strong involvement with his son. |
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Part V Updates on ADHD, Asperger Syndrome and Overlap |
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14 ADHD: Problems in the Brain's Self-Management System |
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The stereotype of ADHD as simply a behavior problem of little boys who are constantly restless and rarely listen to what others say or expect has been replaced with a science-based understanding of ADHD as a complex problem in the unfolding development of the brain's self-management system, its executive functions. |
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This chapter explains that new understanding of ADHD, how it changes across development, and how it can be effectively treated. |
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15 Asperger Syndrome: Problems in the Brain's Social-Emotional System |
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Asperger syndrome is a name for a cluster of characteristics related to social awkwardness and chronic difficulties in understanding one's own and others' emotions and point of view that is found in some children and adults with average or above average intelligence. |
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That syndrome, once a separate diagnosis, was eliminated from the diagnostic manual in 2013 and absorbed into the autism spectrum. |
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This chapter describes Asperger syndrome and advocates for recognizing it as a distinctive subtype within the autism spectrum. |
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16 Overlap and Complications on Complications |
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Multiple research studies have demonstrated that half to two-thirds of those diagnosed with the higher-IQ form of autism previously known as Asperger syndrome also have ADHD. |
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It has also been shown that those on the autism spectrum with symptoms of ADHD tend to have significantly more difficulty with adaptive behavior in school, home and community and tend to benefit from ADHD treatments. |
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Conversely, approximately 18% of a sample of children diagnosed with ADHD also suffered from autistic traits and had more impaired functioning than those with ADHD alone. |
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Additionally, both ADHD and Asperger syndrome are often further complicated by additional disorders involving anxiety, mood, behavior problems and/or specific learning disorders. |
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17 Summary Observations and Resources |
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Each of this book's 12 chapters about individuals includes reflections on that person's situation and efforts to provide support and treatment for them. |
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This chapter offers information and reflections about factors that seem important for many of the children, teens and adults described here as having both ADHD and Asperger syndrome. |
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Some of this information might be useful for adaptation and use with other children, teens, or adults with similar difficulties. |
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Following this information is a listing of books and other resources that offer additional information and support. |
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References |
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Index |
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204 | |